How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $691.83 | Professional | None | $436.52 | $436.52 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $89.13 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $60.26 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $60.26 |
BCBS North Dakota Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,380.38 | Professional | None | $954.99 | $1,174.90 | $1,380.38 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $234.42 Typical High $275.42 | Professional | 55 · Aftercare only | $190.55 | $234.42 | $275.42 |
BCBS North Dakota Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $117.49 Typical High $138.04 | Professional | 56 · Pre-op care only | $95.50 | $117.49 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $954.99 Typical High $1,348.96 | Professional | None | $489.78 | $954.99 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $1,318.26 | Facility | None | $436.52 | $436.52 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $758.58 Typical High $3,630.78 | Professional | None | $436.52 | $758.58 | $3,630.78 |
United Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $933.25 | Professional | None | $407.38 | $645.65 | $933.25 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | 52 · Reduced service | $218.78 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $120.23 | Professional | 53 · Discontinued | $87.10 | $87.10 | $120.23 |
Where North Dakota sits
The same service costs 3.2 times more in Alaska than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Dakota· 5th of 51
$955
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.